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  Tuesday, March 19, 2024
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Companion Guides and Manuals

The Health Insurance Portability and Accountability Act (HIPAA) requires that Medicaid and all other health insurance payers in the United States comply with the EDI standards for healthcare as established by the Secretary of Health Services. The ANSI X12N implementation guides (4010) and Technical Report Type 3-TR3 documents (5010) have been established as the standards of compliance for claim transactions.


This page provides access to information intended to serve only as a companion guide to the HIPAA ANSI X12N implementation guide and TR3 documents. The use of this guide is solely for the purpose of clarification. The information describes specific requirements to be used for processing data. This companion guide supplements, but does not contradict any requirements in the X12N implementation guide or TR3 document.


Additional information on the Final Rule for Standards for Electronic Transactions can be found at http://aspe.hhs.gov/admnsimp/final/txfin00.htm. The HIPAA implementation guides and TR3 documents can be purchased from the Washington Publishing Company Web site at http://www.wpc-edi.com/. Additional information related to HIPAA is also available on the Department of Community Health Web site at www.dch.georgia.gov.


The information in these guides is subject to change. Please check this site periodically to obtain the most current information available from Georgia Medicaid. If you have any questions regarding these companion guides, please contact EDI Services at (877) 261-8785 (toll-free) or (770) 325-9590 (locally).


Accessing the Secure File Transfer Protocol (SFTP) Site


Authorized submitters who have successfully completed the SFTP Setup Request form and the EDI Trading Partner Agreement will receive notification by e-mail within 5-7 business days once they have been configured for SFTP access. Users will need to access the site using their SFTP credentials received in their SFTP Welcome E-mail. Additional Information about how to access the SFTP site is available in the SFTP Setup & Data Transfer Requirements guide below.

Attention Payees Receiving ERAs.
Important: Providers enrolled for Electronic Remittance Advices (ERAs) must activate their Payee Provider Web Portal PINs that they received in the mail.

ERAs are generated using the PAYEE Provider ID; therefore, if you wish to delegate these 835 ERAs so that your clearinghouse/software vendor/billing agent can access these on your behalf, you must provide them access to your file downloads.

Contact your clearinghouse/software vendor/billing agent to get the email address and username that you should grant access to, then follow the instructions in the "Web Portal User Account Management Guide" found on the Provider Manuals page. Refer to section 3.2 titled, "Providers or Trading Partners Delegating Access to a Billing Agent or Trading Partner Account" for detailed instructions.

You will need to grant the "Trade Files Download" role for a user to have access to your 835 ERA file.
PDF Reader Required
NOTE: If you don't have a PDF reader already installed, Adobe Acrobat Reader is required to view these documents. Click here to obtain the latest version of the free Adobe Reader.
File Download Issues
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Companion Guides and Manuals (21 rows returned) List
 
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Companion Guides and Manuals (21 rows returned)

 
 TitleFile TypeSize (KB)Release Date 
GAMMIS 5010 270-271 Companion Guide v2.16PDF1648.610/25/2023 
GAMMIS 5010 276-277 Companion Guide v2.8PDF896.706/01/2023 
GAMMIS 5010 277U Companion Guide v2.8PDF689.206/01/2023 
GAMMIS 5010 820 Companion Guide v2.19PDF729.512/28/2023 
GAMMIS 5010 824 Companion Guide v2.8PDF677.506/01/2023 
GAMMIS 5010 834 Companion Guide v2.30PDF1607.212/28/2023 
GAMMIS 5010 835 Companion Guide v2.9PDF689.406/01/2023 
GAMMIS 5010 837D Companion Guide v2.13PDF810.510/30/2023 
GAMMIS 5010 837I Companion Guide v2.13PDF88710/30/2023 
GAMMIS 5010 837P Companion Guide v2.16PDF827.810/30/2023 
GAMMIS 5010 999 Companion Guide v1.9PDF742.306/01/2023 
GAMMIS 5010 Encounter 837D Companion Guide v2.17PDF887.710/30/2023 
GAMMIS 5010 Encounter 837I Companion Guide v2.17PDF884.210/30/2023 
GAMMIS 5010 Encounter 837P Companion Guide v2.18PDF929.710/30/2023 
GAMMIS 5010 NEMT 820 Companion Guide v2.16PDF651.612/28/2023 
GAMMIS 5010 NEMT 834 Companion Guide v2.9PDF626.106/01/2023 
GAMMIS 5010 NEMT 837P Companion Guide v2.12PDF868.406/01/2023 
GAMMIS EDI Web Services Connectivity Guide v1.7PDF552.711/05/2020 
GAMMIS NCPDP Encounter Companion Guide v5.4PDF408.911/02/2023 
Georgia Ramp Manager User Guide v5.0PDF611.312/29/2022 
SFTP Setup & Data Transfer Requirements v5.3PDF373.812/29/2022 
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